Kapp Marshall B
Int J Risk Saf Med. 2016;28(4):213-219. doi: 10.3233/JRS-170733.
Discussions regarding defensive medical practice often result in proposals for public policy actions. Such proposals generally are premised on assumptions about defensive medicine, namely, that it (a) is driven by physicians' legal anxieties, (b) constitutes bad medical practice, (c) drives up health care costs, (d) varies depending on a jurisdiction's particular tort law climate, (e) depends on medical specialty and a physician's own prior experience as a malpractice defendant, and (f) is a rational response to actual legal risks confronting physicians. This article examines a sample of recent literature focusing on defensive medicine and finds that the messages conveyed vary widely, helping to explain the confusion experienced by many policymakers trying to improve the quality and affordability of health care.
关于防御性医疗行为的讨论往往会引发有关公共政策行动的提议。此类提议通常基于对防御性医疗的假设，即它（a）由医生的法律焦虑所驱动，（b）构成不良医疗行为，（c）抬高医疗成本，（d）因司法管辖区的特定侵权法环境而异，（e）取决于医学专业以及医生自身作为医疗事故被告的既往经历，并且（f）是对医生面临的实际法律风险的理性反应。本文研究了近期一批聚焦防御性医疗的文献样本，发现其中传达的信息差异很大，这有助于解释许多试图提高医疗质量和可及性的政策制定者所感到的困惑。
